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Effective Periodontal Treatment in a Patient With Type IIA von Willebrand's Disease: Report of a Case
Author(s) -
Izumi Yuichi,
Taniguchi Takuro,
Maruyama Yoshikazu,
Sueda Takeshi
Publication year - 1999
Publication title -
journal of periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.036
H-Index - 156
eISSN - 1943-3670
pISSN - 0022-3492
DOI - 10.1902/jop.1999.70.5.548
Subject(s) - medicine , hematologist , von willebrand disease , dentistry , bleeding on probing , periodontist , von willebrand factor , scaling and root planing , periodontal disease , clinical attachment loss , periodontitis , chronic periodontitis , disease , platelet
von Willebrand's disease (vWD) is one of the most common hereditary hemorrhagic disorders. A mild to moderate deficiency of factor VIII and von Willebrand factor (vWf) often is associated with gingival bleeding. In this case report, the periodontal treatment of a patient with vWD is described. A 45‐year‐old woman with type IIA vWD was referred for periodontal therapy because of an episode of gingival hemorrhage and percussion pain of teeth #18 and #47. The periodontal findings included probing depths ranging from 2 to 6 mm, horizontal bone loss, and Class II furcation involvement of tooth #46. After consultation with a hematologist, apically positioned flap surgery and hemisection were performed on tooth #46 following completion of oral hygiene instruction, scaling and root planing, and endodontic therapy. The patient was given 500 units of factor VIII including vWf multimer 30 minutes before surgery. After healing of the periodontal tissue, prosthodontic treatment was undertaken on the posterior mandibular sextants. At follow‐up, the probing depths ranged from 2 to 3 mm, and gingival bleeding on probing was minimal. The patient's children all had vWD. They had mild to moderate periodontitis with probing depths ranging from 2 to 5 mm and gingival bleeding on probing. With the combined efforts of the periodontist and hematologist, effective periodontal treatment can be provided to patients with von Willebrand's disease. J Periodontol 1999;70:548‐553.